| NPI | 1639510753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology (Licence: KY TP792) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MI 4301102762) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2020-01-06 |